Hazardous Materials Cargo Manifest

Shipper Information

Company Name

Contact Person

Phone Number

Email

Address

Consignee Information

Company Name

Contact Person

Phone Number

Email

Address

Shipment Details

Date

Manifest Number

Carrier

Vehicle/Flight Number

Hazardous Materials Details

Proper Shipping Name	UN/ID Number	Class/Division	Packing Group	Quantity	Pkg Type	Emergency Contact	Remarks

Additional Information

Prepared By

Date

Signature